Nursing their way not our way: working with vulnerable and marginalised populations

Wilson, Denise and Neville, Stephen (2008) Nursing their way not our way: working with vulnerable and marginalised populations. Contemporary Nurse, 27 2: 165-176.

Author Wilson, Denise
Neville, Stephen
Title Nursing their way not our way: working with vulnerable and marginalised populations
Journal name Contemporary Nurse   Check publisher's open access policy
ISSN 1037-6178
Publication date 2008-02-01
Sub-type Article (original research)
Volume 27
Issue 2
Start page 165
End page 176
Total pages 12
Editor Jenny Gibson
Place of publication Maleny, Qld. Australia
Publisher eContent Management
Language eng
Subject C1
321199 Nursing not elsewhere classified
321207 Indigenous Health
111099 Nursing not elsewhere classified
111713 Maori Health
Formatted abstract
Aims and objectives:
This paper uses thefindings of two studies to explore the nature of nurses' practice when working with vulnerable and marginalised populations, particularly with regard to the attributes ifholism and individualised care. A secondary analysis of the findings of two separate studies was undertaken, one on the elderly with delirium and the other with indigenous Maori women.


Often considered vulnerable and marginalised, elderly and
indigenous experiences of health services are often fraught with their health needs not always identified or addressed. Nursing claims that holism and individualised care are pivotal attributes underpinning nursing practice. However, the secondary analysis of two research studies highlight how vulnerable and marginalised populations accessing health and nursing services experience needs that are neither acknowledged nor integrated into intervention and treatment plans.


A secondary analysis of one study with the elderly with delirium used
a critical gerontological methodology iriformed by postmodernism and Foucault's understanding of discourse. The other study with indigenous Maori women utilised Glaserian grounded theory iriformed by a Maori-centred methodology.

The research on the elderly with delirium analysed 20 data sources, including interviews with older persons who had experienced delirium, members of their families and health professionals. The research with 38 indigenous Maori women aged between 24 and 65 years, inductively analysed interview data using constant comparative analysis, theoretical sampling and saturation of the core categories to generate a substantive grounded theory.


The findings of each study showed that a problem focussed approach to health care is offered to patients that does not incorporate individual health experiences. In addition, the social context integral to people's lives outside of the health care environment is ignored and as such the very foundations of nursing practice, that of holism, is merely a rhetorical construct.

Vulnerable and marginalised patients experience care that
neglects their perceived health needs and the realities of their life circumstances.
Relevance to clinical practice: Individualised care that extends beyond the
presenting issue is vital, but raises challenges when working with those population groups considered vulnerable and marginalised to improve outcomes of their health experience.
Keyword individualised care
patient centred care
indigenous patient care
elderly patient care
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Nursing, Midwifery and Social Work Publications
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Citation counts: TR Web of Science Citation Count  Cited 14 times in Thomson Reuters Web of Science Article | Citations
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Created: Wed, 05 Aug 2009, 20:45:41 EST by Vicki Percival on behalf of School of Nursing, Midwifery and Social Work